Crises & Quandaries: Lessons from Long-Term Inpatient Treatment of Patients with Complex DID
In reviewing the cases of several patients with extremely complex manifestations of dissociative identity disorder (DID) and complex posttraumatic stress disorder, this presentation will highlight common themes of the clinical presentations (including before a diagnosis of DID was made) and characteristics of the arc of inpatient treatment for such cases. The presentation will review helpful approaches to treatment, including methods for addressing intergenerational dynamics that complicated family work in addition to individual psychotherapy and the maintenance of consistent and helpful boundaries. The presentation will also review dilemmas in discharge/step-down planning that characterize many such cases, and we will present recommendations for outpatient therapists for stabilizing patients with extremely complex DID who have recently been discharged from a psychiatric hospital.
This session was originally presented as a live conference presentation in April 2021.
At the conclusion of this presentation participants will be able to:
- Identify principles for teaching patients with complex PTSD and DID how to establish and maintain helpful boundaries in therapy, in their current relationships, and with relatives
- Describe three significant obstacles that commonly arise when patients with extremely complex DID transition from inpatient to outpatient treatment
- Demonstrate an understanding of common intergenerational and family dynamics and conflicts that may arise while treating patients with extremely complex forms of DID
- Identify three key similarities and differences that characterize the long-term treatment of patients with extremely complex DID versus patients with less complex DID symptomology and/or phenomenology
- Predict challenges in developing a strong therapeutic alliance in treating patients with extremely complex DID
Presenter: Benjamin Israel, MD
Presenter Bio: Dr. Benjamin Israel is a Service Chief, psychiatrist, and psychotherapist at The Trauma Disorders Program at Sheppard Pratt Hospital in Baltimore, MD. In addition to his clinical and administrative roles, he contributes to classroom lectures, runs an inpatient residency rotation focusing on trauma-related disorders, and supervises individual psychotherapy trainees in his role as an Adjunct Assistant Professor at the University of Maryland School of Medicine. Previously he has presented on the diagnosis and treatment of traumatized patients at national psychiatric and psychotherapy conferences. He also serves on the Membership Committee of the American Academy of Psychoanalysis and Dynamic Psychiatry.
Presenter: Sarah Swenson, PsyD
Presenter Bio: Dr. Sarah Swenson, PsyD, is an attending psychologist with the Sheppard Pratt Health System’s Trauma Disorders Program. Dr. Swenson completed a two-year postdoctoral fellowship on the Trauma Disorders Unit before becoming a full-time psychologist at the hospital. She completed her doctoral studies at William James College in Boston, Massachusetts. During her doctoral training, Dr. Swenson worked closely with Dr. Bessel van der Kolk, a leading researcher in traumatic stress, and became immersed in treating complex trauma and dissociative disorders across the lifespan. Dr. Swenson specializes in treating dissociative identity disorder and utilizes an eclectic treatment approach including hypnosis, cognitive techniques, and psychodynamic underpinnings.
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